Questions to Ask Physicians

Birth Planning Questions to Ask Your Physician

When choosing a doctor, it’s important to find one who is in sync with your values and needs. Be sure you clarify your values before you choose your doctor. Take our survey Clarifying Your Values for Birth then you can find one who has similar philosophy about childbirth as you do. You can also check out The Birth Survey and find out what other women have said about your doctor and hospital. See link at bottom of this page. We also recommend you find out if your hospital is a Mother-Friendly and/or Baby-Friendly Hospital. The following questions are based on 10-evidence based steps called The Mother-Friendly Childbirth Initiative (MFCI), a concensus document authored by The Coalition for Improving Maternity Services, a coaltion of over 45 leading organizations with concern for maternal and infant health and were published in the peer-reviewed Journal of Perinatal Education. Download a copy of the journal: Evidence Basis

SUPPORT. Unrestricted access to continuous emotional and physical support from a family member or a labor-support professional; including access to professional midwifery care.

INFORMATION. Provides accurate descriptive and statistical information to the public about its practices and procedures.

CULTURAL COMPETENCY. Provides culturally competent care.

FREEDOM OF MOVEMENT. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth

COLLABORATION. Has clearly defined policies and procedures for collaborating and consulting throughout the perinatal period with other maternity services; linking the mother and baby to appropriate community resources.

EVIDENCE-BASED. Does not routinely employ practices and procedures that are unsupported by scientific evidence, and limits others.

PROMOTES NON-DRUG METHODS OF PAIN RELIEF. Educates staff in non-drug methods of pain relief, and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.

TOUCH.HOLD.BREASTFEED. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.

What is the length of your appointments? How long must I wait to see you?

How many patients do you deliver per month? (over 30 this may mean 5 or 6 per day; long office waits/short dr. visits at prenatal appointments).

If you’re not on call, or busy with another birth, then who will deliver my baby? Do you have partners?

What happens if I go past my due date? (Evidence-based recommendation: labors should not be induced before 39 weeks unless there is a serious medical condition where the risk of medical induction outweighs the risk to mother and fetus of induction, See Step 6 of the MFCI).

For what situations do you induce labor? (Evidence-based recommendation: as induction may increase risk of cesearean section, therefore, it should only be done for a medical reason, and not before 39 weeks gestation, and only after an Estimated Fetal Weight determination is done and a Bishop Score is done to determine favorability of the cervix for induction.See Step 6 of the MFCI).

What percentage of your patients have a Professional Labor Companion/Doula? What do you think of them? Who have you worked with? What do you like/dislike about doulas, and why? What doula would you recommend (if any)? (Evidence based recommendation: Doulas decrease length of labor, decrease need for pain medication, decrease rates of cesarean section, and reduce medical interventions, increase breastfeeding success and decrease maternal depression after delivery. See Step 1 of the MFCI)

How do you feel about my hiring a Monitrice? Have you worked with any? How do you feel about them? (See Step 1 of the MFCI)

Do you work now or have you worked with midwives? How do you feel about them? (See step 1 of the MFCI)

Do you do Vaginal Birth After Previous Cesarean? (VBAC) What is your VBAC rate? (See Step 6 of the MFCI, evidence-based taregt is 75% VBAC rate. For more information go to vbac.com)

Do you deliver twins or breech vaginally?

What is your Cesearean rate? (Evidence-based recommendation: should not be higher than 15%. See Step 6 of the MFCI)

have friends, family members, siblings present at birth? (See Step 1 of the MFCI)

push in any position they like, including out of bed, on floor or toilet? (See Step 4 of the MFCI)

use a squatting bar or birth stool for pushing? (See Step 4 of the MFCI)

14. What is your time limit for latent phase of labor? active phase? pushing?( see Step 6 of the MFCI)

15. What percent of your patients need a vacuum extraction or forceps? (See step 6 of the MFCI)

16. What percentage of your births do you cut episiotomies? (See Step 6 of the MFCI)

17. Do you do perineal massage with mineral oil to ease stretching of my tissues during pushing?

18. Would you be willing to use warm compresses on my perineum?

19. Do you place the baby on the mom’s belly or chest once delivered? can she remain with me for 2 hours after the birth? Even after a cesarean section? (See Step 8 and Step 10 of the MFCI which is to implement the UNICEF-WHO Baby-Friendly Hospital Initiative).

20. Will you wait til the cord has stopped pulsing before cutting the cord?

21. Will you let the baby’s father catch the baby?

22. Will you let me breastfeed the baby to help my placenta deliver instead of giving me pitocin after the birth?

23. How long can I keep the baby with me after birth? (Evidence-based recommendation: 1 hour or more.See step 10 of the MFCI which is to implement the WHO-UNCIEF Baby-Friendly Hospital Initiative).

24. Have labor and delivery nurses been trained in breastfeeding at the hospital? (See Step 10 of the MFCI which is to implement the WHO-UNICEF Baby Friendly Hospital Initiative).

Connect With Us

Who We Are

The Association for Wholistic Maternal and Newborn Health is a training and advocacy organization with a grassroots, community-based approach to support direct-service providers in promoting the health of mothers, infants, and families. Working harmoniously with a variety of maternity care providers including physicians, midwives, doulas and others, we promote family-centered, evidence-based maternity care aimed to reduce perinatal health disparities and improve quality of care. The organization trains perinatal professionals at all levels and in a variety of settings, designs community-based initiatives, engages and mobilizes diverse stakeholders to develop programs and policies that improve maternal and child health.

Testimonials

“I am just buzzing–I mean it feels like every cell in my body is humming with a deep adoration and gratitude for all of you! Thank you for continuing to inspire me and give me direction in my journey. So much food for thought and fuel for action.”

“After taking this course, I plan to embrace my ancestor’s cultural traditions for mothering and breastfeeding and to share the light of women’s wisdom with future generations.”

Sharing the Light -Magdalena, 2015 Course Graduate

“Words cannot express the depth of my positive experience with this organization! Thank you, Earth Angels! The Doulas are compassionate, knowledgeable, intuitive and led by a pure purpose to serve mothers, children & families. There was no agenda other than relieving us of further stress. My husband and I feel completely overwhelmed with gratitude!”

We are so grateful! – Leslie S., Valley Village, CA

“I am forever thankful to have found this organization. My Doula’s knowledge and support throughout my pregnancy jitters were exactly what I needed. She took care of my needs before and after my birth. My doula was present and supportive every step of the way and I had the VBAC birth I wanted.”